• Birth weight <1501 g
• Gestation <32 weeks'
• Requiring IPPV or CPAP for more than a few hours
• Bronchopulmonary dysplasia with prolonged mechanical ventilation at 36 weeks’ postmenstrual age
• Postnatal steroids given <33 weeks’ gestation
• Significant cranial ultrasound abnormality on final scan on NNU
• Acute neonatal encephalopathy grade 2 or 3
• Seizures (of whatever cause)
• Neonatal meningitis
• Neonatal herpes simplex infection
• Blood culture positive neonatal sepsis
• Abnormal neurological examination at discharge
• Severe retinopathy of prematurity
• Neonatal abstinence syndrome requiring treatment (see Abstinence syndrome guideline)
• Exchange transfusion for any reason/immunoglobulin for hyperbilirubinaemia/in-utero transfusion or serum bilirubin >10 x gestational age (weeks) in preterm babies
• Major congenital anomalies (consider early referral to general paediatrician)
• Persistent hypoglycaemia
• Consultant discretion
• Babies who have undergone surgery in early neonatal period

Refer to neonatal follow-up clinic

Follow-up timetables

• These tables are a guide to usual number of appointments according to each neonatal condition
• Adjust follow-up to individual needs
• Follow local policy to book appointments with relevant professionals

High-risk preterm babies born <30 weeks

High-risk babies ≥30 weeks

• See Developmental follow-up of children born preterm guideline 

Babies ≥34 weeks with transient problems (e.g. mild jaundice, feeding problems, hypoglycaemia, culture-negative sepsis etc.)

• May require specific advice to community team/GP about monitoring/follow-up, but usually do not need neonatal follow-up
• See relevant guideline for follow-up for other conditions e.g. syphilis, HIV, hepatitis, cardiac murmurs etc.

Neurodevelopmental problems identified

• Refer to child development centre and/or specialist services e.g. physiotherapist, speech and language therapist and dietitian according to baby’s individual needs 
• Refer to patch consultant community paediatrician
  
  • referral may be made at time problem identified or later if more appropriate for the family
• For complex medical problems, e.g. ongoing cardiac or respiratory disease, shared neonatal follow-up 

Babies with problems identifiable early

• For babies with Down’s syndrome, severe hypoxic ischaemic encephalopathy or at consultant discretion, involve patch consultant community paediatrician and pre-school therapy team early, before discharge if appropriate
• For babies with concurrent medical problems (e.g. cardiac problem, chronic lung disease), arrange co-ordinated follow-up (decided on individual basis following discussion between community and neonatal consultants)
• Refer children with impaired vision and/or hearing to consultant community paediatrician